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11/28
2011
ISSUE:472

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6th International Conference for Food Safety and Quality
(Nov. 8-9, 2011)
, Chicago, IL



Comments from Attendees
Awesome!!! Enjoyed every Minute. Couldn't have asked for a better learning experience.
Rory - Grimmway Farms
This conference was Extremely informative well organized and executed. I will continuously attend again.
Orlean - Golden Krust Caribbean Bakery
Excellent selection of speakers. I would definitely recommend this program to others.
Carl - Annies Inc.
Excellent Speakers. Surely, I will attend the next one. Well organized.
Luis - University of Texas
Enjoyed myself.. Great Great Conference
Leonard -Thermo King
Excellent Experience. I am incredibly happy to have attended. I fully intend on attending the 7th.
Michael - Greater Chicago Food Depository
I can get various information about food safety and quality.
Takeshi - NEC Japan.
Excellent coverage of topics. I will come again.
Tim - bioMerieux
Great Speakers and Great Information
Ellen - Proliant
Excellent 2 days conference very informative presentations. Excellent Resource form all food companies.
Susen- Masterson Co.
Very Interesting and Learned a lot.
Connie - Procter Gamble
and more--

7th International Conference for Food Safety and Quality
Chicago, IL

Main Topic: Detection/Control of Microbiological/Chemical hazards for Food Safety and Quality
send us your email to reserve seats


US reluctantly sets deadline for final decision on bisphenol A safety
Source : http://www.foodproductiondaily.com/Quality-Safety/US-reluctantly-sets-deadline-for-final-decision-on-bisphenol-A-safety
By Rory Harrington(Dec 08, 2011)
The US Food and Drug Administration (FDA) must reach a final decision before 31 March 2012 on whether to ban bisphenol A (BPA) in food and drink packaging following the outcome of a lawsuit.
The federal body made the commitment to finally make a decision on the chemical as part of a court settlement with the Natural Resource Defense Council (NRDC) after a ruling from US District Court for the Southern District of New York.
Final decision not ‘tentative action’
The environmental action group said it took legal action the FDA after the body ignored a request it made in 2008 to outlaw BPA in food packaging.
“More than three years ago, NRDC filed a petition with FDA asking it to ban the use of BPA as a food additive,” said group spokeswoman Suzanne Struglinski. “We waited and we waited, but never got an answer. FDA could have agreed to ban BPA, rejected our petition, or accepted some parts of it and not others, but instead it chose not to respond at all.”
Under federal rules, the FDA has up to 180 days to respond to a written petition, she added. After 18 months of silence, the NRDC decided to file a lawsuit, which led to yesterday’s ruling.
US District Judge Barbara S. Jones backed the agreement obliging the FDA to issue a final decision, not a “tentative response”, over the controversial chemical.
Struglinski added: “While we are glad FDA is finally going to make a decision BPA in food packaging and this is a major step forward in the legal process, it is discouraging that FDA has not responded and that we had to ask the court to intervene just to get FDA to do its job. The agency has been dragging its feet on making a decision about BPA for far too long”
Milestone
In 2010, the FDA issued a statement on BPA which acknowledged “some concerns” about the chemical’s effects on infants and young children and said it supported ”reasonable steps to reduce exposure of infants to BPA in the food supply”.
But the agency was equally clear that it did not believe that overall use of BPA in food packaging posed a health risk. It pledged to carry out further research before reaching a final decision.
BPA is a chemical used in a range of packaging – including the epoxy linings of food and beverage cans. Dozens of scientific studies have raised concerns about its detrimental health effect – both at high and low levels.
However, the majority of global food safety agencies have declared it to poses no health risk through dietary expose. The exception to this is ANSES, the French food safety agency, which raised new concerns earlier this year, leading to its Government passing a law to ban the substance in food packaging from 2014.
Reacting to yesterday’s ruling NRDC lawyer Aaron Colangelo said: “This is a major milestone in this legal battle, and we hope FDA moves to eliminate this dangerous chemical from the food supply. It’s disappointing we were forced to go to court to get the agency to do its job, but we’re happy to see this move forward.”

Radiation-tainted milk formula not in Hong Kong - CFS
Source : http://www.foodproductiondaily.com/Quality-Safety/Radiation-tainted-milk-formula-not-in-Hong-Kong-CFS
(Dec 08, 2011)
Batches of radiation-contaminated Meiji milk powder have not entered the food supply chain in Hong Kong, the region’s food safety authority has confirmed.
According to an announcement by the Hong Kong Food and Environmental Hygiene Department’s Centre for Food Safety (CFS), none of the potentially contaminated batches had entered the market.
The announcement came in response to an investigation by the agency. FoodProductionDaily.com reported earlier this week, that traces of the radioactive substance Cesium had been found in Meiji Step baby milk powder for children aged over 9 months. Japanese manufacturer Meiji Holdings, which produces the milk powder, announced the recall of 400,000 units of the milk formula.
CFS officers met with importers and distributors in order to establish whether affected batches of the formula had been imported into Hong Kong.
Officers now been deployed to inspect retail outlets – so far none of the affected batches have been found.

'Worrying' amount of fake food recovered during European crackdown
Source : http://www.foodproductiondaily.com/Quality-Safety/Worrying-amount-of-fake-food-recovered-during-European-crackdown
By Mark Astley (Dec 08, 2011)
Police, customs and food safety bodies seized a “worrying” amount of counterfeit and substandard food and drink during a Europe-wide fake-food crackdown, authorities have revealed.
Hundreds of tonnes of potentially harmful food and drink items were recovered across 10 European countries, in an operation coordinated by policing authorities Interpol and Europol.
Operation Opson, which involved authorities from across the continent, seized a substantial amount of fake food and drink including champagne, tea, five tonnes of substandard seafood and 12,000 bottles of bootleg wine worth €300,000.
A statement made by Europol reiterated that consumers who buy these products, knowingly or unknowingly, are putting their health at risk.
It added: “Counterfeit food and drink are not subject to any manufacturing quality controls and are transported or stored without proper regard to hygiene standards.”
Potentially dangerous
“The high number of counterfeit and substandard food seized is worrying and it shows the need for close cooperation among law enforcement agencies to stop criminals active in this type of crime,” said Europol project manager Chris Vansteenkiste.
Officials from the UK, Turkey, Spain, Romania, Hungary, Italy, France, Denmark, Bulgaria and the Netherlands took part in the operation, which checks being made in airports, seaports, shops and markets.
More than 13,000 bottles of substandard olive oil, 30 tonnes of fake tomato sauce, around 77,000kg of counterfeit cheese and nearly 30,000 candy bars were also recovered
The internet-sale of fake and substandard caviar is also under investigation.
“One of the main goals of this operation was to protect the public from potentially dangerous fake and substandard food and drinks, which is a threat that most people are not even aware of,” said Interpol officer Simone Di Meo.
Need to raise issue profile
A recent conference on food authenticity revealed that while there is an awareness of food fraud in Europe, there is a definite need to raise its profile and place it on a higher agenda.
Stuart Shotton, consultancy services manager at Food Chain Europe said the conference highlighted the need for better education on how to tackle these issues.
Although it is difficult to pinpoint the true extent of food fraud, food safety authorities are reluctant to “scratch too far beneath the surface in fear of what they might find,” added Shotton.
The UK Food Standards Agency (FSA), which wasn’t involved directly in Operation Opson, has previously urged caution regarding the consumption counterfeit food including illicit vodka.

Radiation traces found in Japanese baby formula
Source :http://www.google.com/hostednews/ap/article/ALeqM5jzxqBS4NYVgB-9xD0nJOm8nI1_IA?docId=5afc9f701da94e259f2f64ea7aaf58d0
By Yuri Kageyama (Dec 08, 2011) 
TOKYO (AP) — Major Japanese food and candy maker Meiji Co. said it was recalling 400,000 cans of powdered milk for infants after traces of radiation from Japan's hobbled nuclear plant were detected in the formula.
The company said it did not know how many of the cans had reached consumers, but acknowledged Wednesday that it was being deluged with queries from worried buyers. The problem milk was manufactured in March and April, and was shipped starting in July with an October 2012 expiration date, it said.
The levels of radioactive cesium detected Tuesday were well below government-set safety limits, and the company said the amounts were low enough not to have any effect on babies' health even if they drank the formula every day.
"We are exchanging it so that people can feel their infants are safe," Meiji said in a statement.
Experts say children are more at risk than are adults of getting cancer and other illnesses from radiation exposure.
"There is no problem because the levels are within the government limit," Kazuhiko Tsurumi, a Health Ministry official in charge of food safety, said of the radiation in Meiji milk.
The March 11 earthquake and tsunami in northeastern Japan sent three reactors into meltdown at the Fukushima Dai-ichi nuclear power plant, and they have been spewing radiation into the air and ocean.
Some of that radiation has crept into food such as rice, fish and beef. But this was the first time radiation was reported in baby formula.
Airborne radioactive cesium contaminated milk as it was being dried at a plant in Saitama prefecture in March, according to Meiji, which has the top market share in Japan in baby formula sales.
It also exports baby milk to Vietnam under a different name, but none of the problem milk was exported to that country, company spokesman Masanobu Nakamura said.
The milk used to make the formula was mostly imported, from Australia and elsewhere. But a small portion of milk from Japan was also used, all from northern Hokkaido farms, which are outside areas that are at radiation contamination risk.
The levels of cesium-134 and cesium-137 in the milk were up to 31 becquerels per kilogram, which is below the government limit of 200 becquerels per kilogram set for milk.
The government has been reviewing its food safety and other radiation standards because some of them were not clearly defined before the nuclear crisis.
Not all food samples are monitored for radiation, and readings have been voluntarily reported by the manufacturers, including the latest by Tokyo-based Meiji.
Many consumers are worried. Some stores are labeling where food was grown or caught, allowing shoppers to opt for imports or products from parts of the country deemed safe.

US rice arsenic level regulations ‘imperative’ - report
Source : http://www.foodproductiondaily.com/Quality-Safety/US-rice-arsenic-level-regulations-imperative-report
By Mark Astley, (Dec 06, 2011)
Related topics: Contamination, Quality & Safety, Cleaning / Safety / Hygiene
Researchers have called on US food safety authorities to regulate arsenic levels in rice, following a report on the risk associated with the contaminant.
The study, which concentrated on the potentially harmful exposure for pregnant women to arsenic, concluded that setting safe legal levels of the contaminant in foodstuffs was essential to protect public health.
Heavy metal arsenic, which is found naturally in the environment, has been linked to several adverse health effects including cancer and cardiovascular disease.
There is also increasing concern over the effects of low-dosage exposure to the heavy metal.
There are currently no safe legal limits on the amount of arsenic in rice products in the US or in Europe.
It is imperative that the Food and Drug Administration (FDA) produce further guidance on safe levels of the heavy metal in rice, added the report.
Further guidance
“There are no statutory limits for the arsenic content of food sold in the United States and European Union, in stark contrast to China, where the maximum safe level of inorganic arsenic in rice is 0.15μg/g (parts per billion [ppb]),” said the study.
Although no safe legal levels have been set in Europe or the US, the European Food Safety Authority (EFSA) has “stressed the need for more data on levels of organic and inorganic arsenic in different foodstuffs, as well as on the relationship between arsenic intake levels and possible health effects,” said the organisation’s website.
The FDA recently recognised the potential health risks associated with arsenic contamination in apple, but no guidance has been set on rice to-date.
“Setting such limits would protect consumers from unknowingly purchasing rice or rice products with high levels of arsenic,” added the report.
“Given the potentially adverse health consequences of arsenic at low levels of exposure, it is imperative that the health impact of arsenic exposure through rice consumption be characterised.”
“Our findings along with others indicate that rice consumption should be considered when designing arsenic reduction strategies in the United States.”
Seriously considering guidance
This report comes after FoodQualityNews.com reported how the FDA was poised to develop new guidelines on the safe legal levels of arsenic in apple juice.
The FDA potential regulation update came as a result of food safety concerns from a consumer group which conducted its own testing for arsenic in apple juice.
Current guidelines dictate that apple juice containing more than 23ppb of organic arsenic represent a potential health risk.
The FDA announced in a reply to the consumer group that it is “seriously considering setting guidance or other level for inorganic arsenic in apple juice and are collecting all relevant information to evaluate and determine an appropriate level.”

Food contact nanomaterial regulations inadequate – report
Source: http://www.foodproductiondaily.com/Quality-Safety/Food-contact-nanomaterial-regulations-inadequate-report
By Mark Astley, (Dec 06, 2011)
US food contact nanomaterial regulations are inadequate to ensure human health, said a report on the technology.
The study, Sourcing Framework for Food and Food Packaging Products Containing Nanomaterials, suggests that food packaging companies need to assess the potential risks associated with exposure to nanoparticles used in the manufacturer of food packaging materials.
Nanomaterials are engineered to take advantage of unique properties at the nano-scale – from 1-1000nm (nanometres or billionths of one metre).
Guidance on the technology’s use in the food sector has been set by the European Food Safety Authority (EFSA), and similar advice has been issued by the International Organisation for Standardisation.
However, no solid regulatory guidance has been set by the US Food and Drug Administration (FDA) to-date.
The framework, published by corporate responsibility group As You Sow, suggests toxicity risks related to the use of nanotechnology in food packaging “remain very poorly understood,” through this lack of regulatory control.
Inadequate controls
“Current regulatory controls are inadequate to assess or ensure safety and the scientific consensus is that there is a lack of knowledge regarding how nanomaterials interact at the molecular or physiological levels and their potential impacts on health and the environment.”
The food industry is working extensively to developing nanomaterials for use in food packaging – despite human exposure risks being unknown.
“As food and food packaging companies explore the use of nanomaterials to enhance products, they need also attend to potential risks introduced,” added the report.
The FDA is yet to establish any regulations to confront the potential risks involved with the use of nanomaterials in the food sector.
A draft guidance document, issued earlier this year is the “first step towards providing regulatory clarity on FDA’S approach to nanotechnology,” said the agency’s website.
The FDA stated that it “believes that evaluations of safety, effectiveness or public health impact of such products (containing nanomaterials) should consider the unique properties and behaviours that nanomaterials may exhibit.”
Health risks
Nanoparticles can gain access to the body through inhalation, ingestion, skin penetration and injection.
Inhaled nano-particles have been found in areas of the respiratory tract and when ingested these particles have been known to pass into the blood where they can target bone marrow, lymph nodes and the heart, said the report.
“New nano-food products should only be used if safety testing ensures that there are no negative impacts on human health or the environment.”
The report added that “to assure safety, companies should require full testing data related to exposure via ingestion, the skin, inhalation, and other membranes including how each nanomaterial behaves as it moves through the body.”

It is time for the American Meat Institute (AMI) to put consumer safety first
Source : http://www.marlerblog.com/lawyer-oped/it-is-time-for-the-american-meat-institute-ami-to-put-consumer-safety-first/
By Bill Marler (Dec 06, 2011 )
Beginning March 5, 2012, after years of discussion, Food Safety Inspection Services (FSIS) finally intends to do sampling and testing of manufacturing trim and other raw ground beef products, to ensure control of both E. coli O157:H7 and six other serotypess of STEC E. coli (O26, O45, O103, O111, O121, and O145) – a.k.a. “The Big Six.”
FSIS has determined after years of research, that along with E. coli O157:H7, these six serotypes are adulterants in non-intact raw beef products and trim within the meaning of the Federal Meat Inspection Act. The import of a finding that these serotypes of STEC’s are adulterants is, if FSIS or a manufacturer finds any of those serogroups in these types of products, it will prohibit the product from entering commerce – consumers will not eat it.
FSIS further found that like E. coli O157:H7, these serotypes cause severe illness and even death, and that young children and the elderly are at highest risk. The Centers for Disease Control and Prevention also identified these serotypes as responsible for the greatest numbers of non-O157 STEC illnesses, hospitalizations and deaths in the United States.
According to FSIS, manufacturers can rely upon the FSIS laboratory methodology released in October and updated on November 4, 2011, which has been demonstrated to reliably identify these pathogens, or they can use an equivalent methodology of their choice.
The AMI has called on FSIS to delay the implementation of testing “The Big Six,” and to not even deem these serotypes adulterants. AMI claims the costs of implementation is too high, that the testing is not yet accurate enough to prevent false positives, and, that not enough people seem to be getting sick - yet. AMI made these same arguments, and others, in 1994 when it unsuccessfully sued FSIS to stop the listing of E. coli O157:H7 as an adulterant. AMI was wrong then and it is wrong now.
AMI has never embraced that fact that getting all pathogenic E. coli out of our meat supply is good for consumers and good for AMI members. Fact - from 1993-2002 100’s of the millions were paid by meat companies to E. coli O157:H7 victims, mainly children. It took a decade for the entire industry to step up, but E. coli O157:H7 cases linked to hamburger are a small part of what we do because the industry met my challenge to “put me out of business.” Banning “The Big Six” will benefit consumers and AMI members.
AMI, just because you can argue about something does not mean you should. It is time to put the safety of consumers, and the good of your members, ahead of the arguing about anything that in your mind justifies your existence.

What the Hell is Salmonella? Chicken Livers, Turkey Burgers and Pine Nuts
Source : http://www.foodpoisonjournal.com/food-poisoning-information/what-the-hell-is-salmonella-chicken-livers-turkey-burgers-and-pine-nuts/
By Bill Marler (Dec 04, 2011)
Kosher Broiled Chicken Livers Salmonella Heidelberg - According to the CDC, between April 1 to November 16, 2011, a total of 179 illnesses due to Salmonella Heidelberg with this PFGE pattern were reported in states where the “kosher broiled chicken livers” were distributed. The number of ill persons identified in each state the product is distributed to is as follows: New York (99), New Jersey (61), Pennsylvania (10), Maryland (6), Ohio (2), and Minnesota (1). Rhode Island and Florida have not identified any cases linked to this outbreak during this period. Among persons for whom information is available in in these states, ill persons range in age from <1 to 97 years with a median age of 13 years. Forty-nine percent are female. Among the 126 ill persons with available information, 25 (20%) have been hospitalized.
Salmonella Heidelberg Turkey Burgers - According to the CDC a total of 136 persons infected with the outbreak strain of Salmonella Heidelberg were reported from 34 states with illness onset dates between February 27 and September 13, 2011. The number of ill persons identified in each state was as follows: Alabama (1), Arkansas (1), Arizona (3), California (7), Colorado (4), Connecticut (1), Georgia (2), Illinois (16), Indiana (2), Iowa (2), Kansas (3), Kentucky (2), Louisiana (1), Massachusetts (4), Maryland (1), Michigan (12), Minnesota (2), Mississippi (2), Missouri (7), Nebraska (2), Nevada (1), New Jersey (1), New York (3), North Carolina (4), Ohio (12), Oklahoma (2), Oregon (1), Pennsylvania (8), South Dakota (3), Tennessee (2), Texas (18), Utah (1), Vermont (1), and Wisconsin (4).
Turkish Pine Nuts Salmonella Enteritidis - A total of 42 individuals infected with the outbreak strain of Salmonella Enteritidis have been reported from 6 states. The number of ill persons identified in each state with the outbreak strain is as follows: Arizona (1), Maryland (1), New Jersey (2), New York (26), Pennsylvania (8), and Virginia (4). Turkish pine nuts sold in bulk bins at Wegmans grocery stores, and some Turkish pine nuts consumed as an ingredient in prepared foods, such as Caprese salad or asparagus with pine nuts, sold at Wegmans stores, have been linked to an outbreak of Salmonella Enteritidis. According to the CDC, among 30 ill persons for whom information is available, 19 (63%) reported consuming Turkish pine nuts or products containing these pine nuts in the week before their illness began.
What is Salmonella?
Salmonella is one of the most common enteric (intestinal) infections in the United States. Salmonellosis (the disease caused by Salmonella) is the second most common foodborne illness after Campylobacter infection. It is estimated that 1.4 million cases of salmonellosis occur each year in the U.S.; 95% of those cases are foodborne-related. Approximately 220 of each 1000 cases result in hospitalization and eight of every 1000 cases result in death. About 500 to 1,000 or 31% of all food-related deaths are caused by Salmonella infections each year. Salmonellosis is more common in the warmer months of the year.
Salmonella infection occurs when the bacteria are ingested, typically from food derived from infected food-animals, but it can also occur by ingesting the feces of an infected animal or person. Food sources include raw or undercooked eggs/egg products, raw milk or raw milk products, contaminated water, meat and meat products, and poultry. Raw fruits and vegetables contaminated during slicing have been implicated in several foodborne outbreaks.
Symptoms of Salmonella infection
The acute symptoms of Salmonella gastroenteritis include the sudden onset of nausea, abdominal cramping, and bloody diarrhea with mucous. Fever is almost always present. Vomiting is less common than diarrhea. Headaches, myalgias (muscle pain), and arthralgias (joint pain) are often reported as well. The onset of symptoms usually occurs within 6 to 72 hours after the ingestion of the bacteria. The infectious dose is small, probably from 15 to 20 cells.
Reiter’s Syndrome, which includes and is sometimes referred to, as reactive arthritis is an uncommon, but debilitating, result of a Salmonella infection. The symptoms of Reiter’s Syndrome usually occur between one and three weeks after the infection. Reiter’s Syndrome is a disorder that causes at least two of three seemingly unrelated symptoms: reactive arthritis, conjunctivitis (eye irritation), and urinary tract infection. The arthritis associated with Reiter’s Syndrome typically affects the knees, ankles, and feet, causing pain and swelling. Wrists, fingers and other joints can be affected, though with less frequency. With Reiter’s Syndrome, the affected person commonly develops inflammation where the tendon attaches to the bone, a condition called enthesopathy. Some people also develop heel spurs, bony growths in the heel that cause chronic or long-lasting foot pain. Arthritis from Reiter’s Syndrome can also affect the joints of the back and cause spondylitis, inflammation of the vertebrae in the spinal column. The duration of reactive arthritis symptoms can vary greatly. Most of the literature suggests that the majority of affected persons recover within a year. The condition, can, however, be permanent.
Detection and treatment of Salmonella Infection
Salmonella bacteria are discovered in stool cultures. Although blood cultures are rarely positive, bacteremia (bacteria in the blood stream) does occur in 5% of adults with Salmonella gastroenteritis and can result in spread to the heart (endocarditis), spleen, bone (osteomyelitis), and joints (Reiter’s Syndrome or reactive arthritis). However, blood cultures are often not performed and in most cases the blood stream is not infected. In the stool, the laboratory is challenged to pick out Salmonella from many other similar bacteria that are normally present. In addition, many persons submit cultures after they have started antibiotics, which may make it even more difficult for a microbiology lab to grow Salmonella. So, the diagnosis of salmonellosis may be problematic and many mild cases are culture negative.
Salmonella infections usually resolve in five to seven days, and many times require no treatment, unless the affected person becomes severely dehydrated or the infection spreads from the intestines. Persons with severe diarrhea may require rehydration, often with intravenous fluids. Treatment with antibiotics is not usually necessary, unless the infection spreads from the intestines, or otherwise persists, in which case the infection can be treated with ampicillin, gentamicin, trimethoprim/sulfamethoxazole, or ciprofloxacin. Some Salmonella bacteria have become resistant to antibiotics, possibly as a result of the use of antibiotics to promote the growth of feed animals.
For those persons who develop Reiter’s Syndrome, symptomatic treatment with high doses of a nonsteroidal anti-inflammatory drug and steroid injections into affected joints can be helpful in reactive arthritis. For people with severe joint inflammation, injections of corticosteroids directly into the affected joint may reduce inflammation. A small percentage of patients with reactive arthritis have severe symptoms that cannot be controlled with these treatments, in which case medicine that suppresses the immune system, such as sulfasalazine or methotrexate, may be effective. Exercise, when introduced gradually, may help improve joint function. Topical corticosteroids can be applied directly on the skin lesions associated with reactive arthritis.
Preventing Salmonella Infection
To prevent salmonellosis, cook poultry, ground beef, and eggs thoroughly before eating. In order to insure that eggs do not contain viable Salmonella they must be cooked at least until the yoke is solid, and meat and poultry must reach 160∫F or greater throughout. Be particularly careful with foods prepared for infants, the elderly, and those with a compromised immune system.
Do not eat or drink foods containing raw eggs, such as homemade eggnog and hollandaise sauce. Avoid drinking raw (unpasteurized) milk or products made from raw milk.
Wash hands, kitchen work surfaces, and utensils with soap and water immediately after they have been in contact with foods of animal origin. Also, wash hands with soap after handling reptiles, amphibians or birds, or after contact with pet feces. Infants and immunocompromised persons should have no direct or indirect contact with such pets.
Salmonella Infection Complications
The following infections result in very few people, but the few who are diagnosed will suffer for the rest of their lives.
Irritable Bowel Syndrome (IBS)
A recently published study surveyed the extant scientific literature and noted that post-infectious irritable bowel syndrome (PI-IBS) is a common clinical phenomenon first described over five decades ago. The Walkerton Health Study further notes that:
Between 5% and 30% of patients who suffer an acute episode of infectious gastroenteritis develop chronic gastrointestinal symptoms despite clearance of the inciting pathogens.
In terms of its own data, the “study confirm[ed] a strong and significant relationship between acute enteric infection and subsequent IBS symptoms.” The WHS also identified risk factors for subsequent IBS, including: younger age; female sex; and four features of the acute enteric illness—diarrhea for > 7days, presence of blood in stools, abdominal cramps, and weight loss of at least ten pounds.
Irritable bowel syndrome (IBS) is a chronic disorder characterized by alternating bouts of constipation and diarrhea, both of which are generally accompanied by abdominal cramping and pain. In one recent study, over one-third of IBS sufferers had had IBS for more than ten years, with their symptoms remaining fairly constant over time. IBS sufferers typically experienced symptoms for an average of 8.1 days per month.
As would be expected from a chronic disorder, IBS sufferers required more time off work, spent more days in bed, and more often cut down on usual activities, when compared with non-IBS sufferers. And even when able to work, a significant majority (67%), felt less productive at work because of their symptoms. IBS symptoms also have a significantly deleterious impact on social well-being and daily social activities, such as undertaking a long drive, going to a restaurant, or taking a vacation. Finally, while a patient’s psychological state may influence the way in which he or she copes with illness, and responds to treatment, there is no evidence that supports the theory that psychological disturbances in facts cause IBS or its symptoms.
Reiter’s Syndrome
Several bacteria, including Salmonella, induce septic arthritis. The resulting joint pain and inflammation can resolve completely over time or permanent joint damage can occur. In a small number of persons, the joint inflammation is accompanied by conjunctivitis and uveitis, (inflammation of the eyes), and cystitis (painful urination). This triad of symptoms is called Reiter's Syndrome. Reiter’s Syndrome is a special form of reactive arthritis, autoimmune disorder triggered by the Salmonella infection. It occurs in persons with a genetic predisposition and can last for a year or more. Antibiotic treatment does not make a difference in whether or not the person later develops arthritis.
The term reactive arthritis refers to an inflammation of one or more joints, following an infection localized at another site distant from the affected joints. The predominant site of the infection is the gastrointestinal tract. During outbreaks of Salmonella infections, reactive arthritis incidences from 1% to 15% have been reported.

Deadly Listeria Cantaloupe Count - 30 Dead, 1 Miscarriage with 146 Sick
Source : http://www.marlerblog.com/legal-cases/deadly-listeria-cantaloupe-count---30-dead-1-miscarriage-with-146-sick/
By Bill Marler (Dec 08, 2011)
A total of 146 persons infected with any of the four outbreak-associated strains of Listeria monocytogenes were reported to CDC from 28 states. The number of infected persons identified in each state was as follows: Alabama (1), Arkansas (1), California (4), Colorado (40), Idaho (2), Illinois (4), Indiana (3), Iowa (1), Kansas (11), Louisiana (2), Maryland (1), Missouri (7), Montana (1), Nebraska (6), Nevada (1), New Mexico (15), New York (2), North Dakota (2), Oklahoma (12), Oregon (1), Pennsylvania (1), South Dakota (1), Texas (18), Utah (1), Virginia (1), West Virginia (1), Wisconsin (2), and Wyoming (4).
Among persons for whom information was available, reported illness onset ranged from July 31, 2011 through October 27, 2011. Ages ranged from <1 to 96 years, with a median age of 77 years. Most ill persons were over 60 years old. Fifty-eight percent of ill persons were female. Among the 144 ill persons with available information on whether they were hospitalized, 142 (99%) were hospitalized.
Thirty deaths were reported: Colorado (8), Indiana (1), Kansas (3), Louisiana (2), Maryland (1), Missouri (3), Nebraska (1), New Mexico (5), New York (2), Oklahoma (1), Texas (2), and Wyoming (1). Among persons who died, ages ranged from 48 to 96 years, with a median age of 82.5 years. In addition, one woman pregnant at the time of illness had a miscarriage.
Seven of the illnesses were related to a pregnancy; three were diagnosed in newborns and four were diagnosed in pregnant women. One miscarriage was reported.

Romaine lettuce E. coli outbreak and hemolytic uremic syndrome (HUS)
Source : http://www.foodpoisonjournal.com/foodborne-illness-outbreaks/romaine-lettuce-e-coli-outbreak-and-hemolytic-uremic-syndrome-hus/
By Drew Falkenstein (Dec 08, 2011)
60 sick people certainly have a right to know who produced the lettuce that made them ill, particularly the families of those folks who developed hemolytic uremic syndrome.  The CDC reports that there are 2 cases of HUS in the romaine lettuce E. coli outbreak, which caused most of its damage amongst customers of Missouri's Schnuck's grocery stores, but there are certainly more.  Regardless of how many, as a result of their HUS illnesses, all of them are now at a significantly increased risk of developing long-term cardiovascular and kidney problems.
What is Hemolytic Uremic Syndrome?
Hemolytic uremic syndrome is a severe, life-threatening complication of an E. coli bacterial infection that was first described in 1955, and is now recognized as the most common cause of acute kidney failure in childhood. E. coli O157:H7 is responsible for over 90% of the cases of HUS that develop in North America. In fact, some researchers now believe that E. coli O157:H7 is the only cause of HUS in children. HUS develops when the toxin from E. coli bacteria, known as Shiga-like toxin (SLT) [1,2], enters cells lining the large intestine. The Shiga-toxin triggers a complex cascade of changes in the blood. Cellular debris accumulates within the body’s tiny blood vessels and there is a disruption of the inherent clot-breaking mechanisms. The formation of micro-clots in the blood vessel-rich kidneys leads to impaired kidney function and can cause damage to other major organs.
What are the Symptoms associated with Hemolytic Uremic Syndrome?
About ten percent of individuals with E. coli O157:H7 infections (mostly young children) goes on to develop Hemolytic Uremic Syndrome, a severe, potentially life-threatening complication. HUS is an extremely complex process that researchers are still trying to fully explain.
Its three central features describe the essence of Hemolytic Uremic Syndrome: destruction of red blood cells (hemolytic anemia), destruction of platelets (those blood cells responsible for clotting, resulting in low platelet counts, or thrombocytopenia), and acute renal failure. In HUS, renal failure is caused when the nephrons, or filtering units, become occluded (blocked) by micro-thrombi, which are tiny blood clots. In almost all cases, the filtering ability of the kidneys recovers as the body of the patient slowly dissolves the micro-thrombi within the microvessels.
A typical person is born with about one million filtering units, called nephrons, in each kidney. The core of the nephron is a bundle of tiny blood vessels, called a glomerulus, where osmotic exchange allows for the filtration of wastes that eventually collect in the urine and are excreted. During Hemolytic Uremic Syndrome, the lack of blood flow to the nephrons can cause them to die or be damaged, just as heart muscle can die as the result of coronary vessel occlusion during a heart attack. Dead nephrons do not regenerate.
In general, the longer a patient suffers kidney failure, the greater the loss of filtering units as a result. At some point, the damage to the kidneys’ filtering units can be so severe that the patient will, over a period of years, lose kidney function and suffer end-stage renal disease (ESRD), which requires chronic dialysis or transplantation.
HUS can also cause transient or permanent damage to other organs, which include the pancreas, liver, brain, and heart. The essential pathogenic process is the same regardless of the organ affected: microthrombi inhibit necessary blood flow and cause tissue death or damage. During the acute stage of Hemolytic Uremic Syndrome, patients must be carefully monitored for these extra-renal complications. It is very difficult to predict the severity and course of HUS once it initiates.
The active stage of Hemolytic Uremic Syndrome may be defined as that period of time during which there is evidence of hemolysis and the platelet count is less than 100,000. In HUS, the active stage usually lasts an average of six days (range, 2-16 days). It is during the active stage that the complications of HUS per se usually occur.
What are the complications and long-term risks associated with Hemolytic Uremic Syndrome?
Several studies have demonstrated that children with HUS who have apparently recovered will develop hypertension, urinary abnormalities and/or renal insufficiency during long-term follow-up.
End Stage Renal Disease, Dialysis and Kidney Transplantation
End Stage Renal Disease
Children and adolescents with chronic renal failure face a number of complications from the condition, including alterations in calcium and phosphate balance and renal osteodystrophy (softening of the bones, weak bones and bone pain), anemia (low blood cell count that leads to a lack of energy), growth failure (final height as an adult substantially below normal), hypertension (high blood pressure), and other complications.
Renal osteodystrophy (softening of the bones) is an important complication of chronic renal failure. Bone disease is nearly universal in patients with chronic renal failure; in some children, symptoms are minor to absent while others may develop bone pain, skeletal deformities and slipped epiphyses (abnormal shaped bones and abnormal hip bones) and have a propensity for fractures with minor trauma. Treatment of the bone disease associated with chronic renal failure includes control of serum phosphorus and calcium levels with restriction of phosphorus in the diet, supplementation of calcium, the need to take phosphorus binders, and the need to take medications for bone disease.
Anemia is a very common complication of chronic renal failure. The kidneys make a hormone that tells the bone marrow to make red blood cells and this hormone is not produced in sufficient amounts in children with chronic renal failure. Thus, children with chronic renal failure gradually become anemic while their chronic renal failure is slowly progressing. The anemia of chronic renal failure is treated with human recombinant erythropoietin (a shot given under the skin one to three times a week or once every few weeks with a longer acting human recombinant erythropoietin).
Growth failure ultimately leading to short height as an adult is a very common complication of chronic renal failure in children. The mechanisms of growth failure are complex and due to multiple causes. Poorly controlled renal osteodystrophy (bone disease), inadequate nutrition (insufficient intake of adequate calories), chronic acidosis (blood system too acid) and abnormalities of the growth hormone axis (growth hormone deficiency) are each major contributors to poor growth in the child with chronic renal failure. Growth hormone therapy with human recombinant growth hormone has been approved for use in children with chronic renal failure and such therapy has been shown to accelerate growth, induce persistent catch up growth and lead to normal adult height in children with chronic renal failure. Growth hormone therapy requires giving a shot under the skin once a day. Complications of growth hormone therapy are rare but may include glucose intolerance and exacerbation of poorly controlled renal osteodystrophy.
Dialysis and Kidney Transplantation
Renal replacement therapy can be in the form of dialysis (peritoneal dialysis or hemodialysis) or renal transplantation.
If the patient does not have a living related donor for their first kidney transplant and when they need a second kidney transplant after loss of the first transplant, they will need dialysis until a subsequent transplant can be performed. The patient can be on peritoneal dialysis or on hemodialysis.
Peritoneal dialysis has been a major modality of therapy for chronic renal failure for several years. Continuous Ambulatory Peritoneal Dialysis (CAPD) and automated peritoneal dialysis also called Continuous Cycling Peritoneal Dialysis (CCPD) are the most common forms of dialysis therapy used in children with chronic renal failure. In this form of dialysis, a catheter is placed in the peritoneal cavity (area around the stomach); dialysate (fluid to clean the blood) is placed into the abdomen and changed 4 to 6 times a day. Parents and adolescents are able to perform CAPD/CCPD at home. Peritonitis (infection of the fluid) is a major complication of peritoneal dialysis.
Hemodialysis has also been used for several years for the treatment of chronic renal failure during childhood. During hemodialysis, blood is taken out of the body by a catheter or fistula and circulated in an artificial kidney to clean the blood. Hemodialysis is usually performed three times a week for 3-4 hours each time in a dialysis unit.
Renal transplantation can be from a deceased or a living related donor (parent or sibling who is over the age of 18 who is compatible). Should the patient have a living related donor available to donate a kidney, they can undergo transplantation without the need for dialysis (preemptive transplantation). Should they not have a living related donor, they will likely need to undergo dialysis while on the waiting list for a deceased donor transplant. Fortunately, children have the shortest waiting time on the deceased donor transplant list. The average waiting time for children age 0-17 years is approximately 275-300 days while the average waiting time for patient’s age 18-44 years is approximately 700 days.
Following transplantation, the patient will need to take immunosuppressive medications for the remainder of their life to prevent rejection of the transplanted kidney. Medications used to prevent rejection have considerable side effects. Corticosteroids are commonly used following transplantation. The side effects of corticosteroids are Cushingnoid features (fat deposition around the cheeks and abdomen and back), weight gain, emotional liability, cataracts, decreased growth, osteomalacia and osteonecrosis (softening of the bones and bone pain), hypertension, acne and difficulty in controlling glucose levels. The steroid side effects, particularly the effects on appearance, are difficult for children, especially teenagers, and non compliance do to the side effects of medications is a risk in children; again, particularly teenagers.
Cyclosporine and/or tacrolimus are also commonly used as immunosuppressive medications following transplantation. Side effects of these drugs include hirsutism (increased hair growth), gum hypertrophy, interstitial fibrosis in the kidney (damage to the kidney), as well as other complications. Meclophenalate is also commonly used after transplantation (sometimes imuran is used); each of these drugs can cause a low white blood cell count and increased susceptibility to infection. Many other immunosuppressive medications and other medications (anti-hypertensive agents, anti-acids, etc) are prescribed in the postoperative period.
Life long immunesuppression, as used in patients with kidney transplants, is associated with several complications including an increased susceptibility to infection, accelerated atherosclerosis (hardening of the arteries), increased incidence of malignancy (cancer) and chronic rejection of the kidney.
United States Renal Data Systems (USRDS) report that the half-life (time at which 50% of the kidneys are still functioning and 50% have stopped functioning) is 10.5 years for a deceased transplant in children age 0-17 years and 15.5 years for a living related transplant in children 0-17 years. Similar data for a transplant at age 18 to 44 years is 10.1 years and 16.0 years for a deceased donor and a living related donor, respectively. Thus, depending upon the age when the patient receives their first transplant they may need 2-3 transplants over the course of their life.
Thus, the life expectancy of a person with a kidney transplant is significantly less than the general population and the life expectancy of a person on dialysis is markedly less than the general population.
Hemolytic uremic syndrome patient follow-up
Children who appear to have recovered from HUS may develop late complications. A precise determination of the risk of late complications is not likely. It is important to note that the risks of longer term (more than 20 years) complications are unknown and are likely to be higher than risks at 10 years, as many of the above studies describe.
A nephrologist—a kidney specialist—should formally evaluate all persons who have experienced HUSat a year following their acute illness. Kidneys injured by HUS may slowly recover function over at least a six-month period following the acute episode and perhaps longer. Even persons with “mild” HUS who did not require dialysis should be formally evaluated. Such an evaluation should include a routine physical, blood pressure measurement, and blood and urine analyses from which kidney filtration rate can be calculated.
Studies done to date on HUS outcomes have largely confirmed a positive correlation between more severe kidney involvement acutely, particularly the need for extended dialysis, and increased incidence of future renal complications. However, it has been shown in multiple studies that even moderate kidney compromise in the acute phase of HUS can result in long-term complications due to damage to the filtering units in the kidneys.
Among survivors of HUS, estimates are that about five percent will eventually develop end stage kidney disease, with the resultant need for dialysis or transplantation, and another five to ten percent experience neurological or pancreatic problems which significantly impair quality of life. Since the longest available follow-up studies of HUS are about twenty (20) years, an accurate lifetime prognosis is not available, and as such, medical follow-up is indicated for even the mildest affected cases.
[1] Recent research suggests that E. coli O157:H7 acquired its pathological character when a bacteriophage (virus that infects bacteria) transmitted genetic material for the creation of the toxin from a closely related Shigella bacterial species (hence the epithet, Shiga-like toxin) to a formerly benign species of E. coli.
[2] Verotoxin-globotriaosyl ceramide binding receptors.

Prior E. coli Outbreaks Tied to Lettuce
Source : http://www.foodpoisonjournal.com/foodborne-illness-outbreaks/prior-e-coli-outbreaks-tied-to-lettuce/
By David Babcock (Dec 08, 2011)
Contamination with different strains of E. coli, and in particular E. coli O157:H7, has been a recurrent problem in lettuce and other leafy greens.  Yesterday, the CDC reported that 60 people were infected with E. coli O157:H7 in 10 states as a result of exposure to romaine lettuce from a single grower and distributor. 
Bill Marler has posted a long list of leafy greens outbreaks on his blog.  The California Food Emergency Response Team collected detailed information on roughly a dozen of these outbreaks that were ultimately linked to products in California, through 2006.
The attorneys at Marler Clark have represented clients in many of these outbreaks as well, including the following:
•2010, E. coli O145 in Lettuce:  Marler Clark filed a lawsuit on behalf of an Ohio resident who was among 33 confirmed and probable illnesses from 4 states tied to Freshway romaine lettuce.
•2008 E. coli O157:H7 Lettuce:  Marler Clark represented a number of clients in an outbreak involving at least 45 illnesses among residents in Michigan, Illinois, and Ontario, Canada.  The outbreak was tied to iceberg lettuce from Aunt Mid's.
•2006 E. coli O157:H7 Spinach:  Attorneys at Marler Clark represented 93 victims of the massive, nationwide outbreak tied to bagged spinach from Dole and Natural Selections.
•2006 E. coli O157:H7 Lettuce:  Our firm represented 6 victims in a multi-state outbreak of E. coli O157:H7 tied to Taco Bell restaurants.  Lettuce in the meals was reported as a possible source of the outbreak.
•2005 E. coli O157:H7 Lettuce:  At least 23 people in Minneapolis and St. Paul, Minnesota, were confirmed ill with E. coli infections after eating contaminated Dole brand lettuce.   Marler Clark represented a number of the victims.
•2002 E. coli O157:H7 Lettuce:  Marler Clark represented several clients, most of them children, sickened in an outbreak of E. coli O157:H7 centered in Spokane, Washington, tied to romaine lettuce.

60 Ill with E. coli in Arizona, Arkansas, Georgia, Illinois, Indiana, Kansas, Kentucky, Minnesota, Missouri and Nebraska Due to Romaine Lettuce
Source : http://www.foodpoisonjournal.com/foodborne-illness-outbreaks/60-ill-with-e-coli-in-arizona-arkansas-georgia-illinois-indiana-kansas-kentucky-minnesota-missouri-a/
By Bill Marler (Dec 07, 2011)
The CDC reported today that 60 persons have been infected with the outbreak strain of E. coli O157:H7 in 10 states. The number of ill persons identified in each state is as follows: Arizona (1), Arkansas (2), Georgia (1), Illinois (9), Indiana (2), Kansas (3), Kentucky (1), Minnesota (3), Missouri (37), and Nebraska (1).
Collaborative investigative efforts of state, local, and federal public health agencies indicate that romaine lettuce sold primarily at several locations of a single grocery store chain (Schnucks) was the likely source of illnesses in this outbreak. Contamination likely occurred before the product reached Schnucks locations.
Ill persons reported purchasing salads from salad bars at Schnucks between October 5 and October 24, 2011. A total of 9 locations of Schnucks were identified where more than one ill person reported purchasing a salad from the salad bar in the week before becoming ill. This included 2 separate locations where 4 ill persons reported purchasing a salad at each location. For locations where more than one ill person reported purchasing a salad from the salad bar and the date of purchase was known, dates of purchase were all within 4 days of other ill persons purchasing a salad at that same location. Romaine lettuce served on salad bars at all locations of Schnucks had come from a single lettuce processing facility via a single distributor. This indicates that contamination of romaine lettuce likely occurred before the product reached Schnucks locations.
The FDA and several state agencies conducted traceback investigations for romaine lettuce to try to identify the source of contamination. Traceback investigations focused on ill persons who had eaten at salad bars at several locations of Schnucks and ill persons at university campuses in Minnesota (1 ill person) and Missouri (2 ill persons). Traceback analysis determined that a single common lot of romaine lettuce harvested from Farm A was used to supply Schnucks locations as well as the university campus in Minnesota during the time of the illnesses. This lot was also provided to a distributor that supplied lettuce to the university campus in Missouri, but records were not sufficient to determine if this lot was sent to this university campus. Preliminary findings of investigation at Farm A did not identify the source of the contamination. Farm A was no longer in production during the time of the investigation.

Fat Duck had single worst restaurant norovirus outbreak, says study
Source : http://www.guardian.co.uk/lifeandstyle/2011/dec/05/fat-duck-restaurant-noroviris-outbreak
By James Meikle(Dec 05, 2011)
A food poisoning outbreak at Heston Blumenthal's Fat Duck restaurant nearly three years ago was the biggest linked to norovirus contamination at a restaurant ever recorded, according to a report.
At least 240 people had gastroenteritis, with symptoms such as nausea, vomiting and diarrhoea, in the outbreak that caused the temporary closure of the Fat Duck in Bray, Berkshire. Contaminated oysters and handling of food by infected staff were said to be the likely causes.
An anonymised report, published online in the journal Epidemiology and Infection concentrates only on a proportion of those affected.
The much-publicised outbreak in January and February 2009 resulted in a critical official report from the Health Protection Agency in September 2009.
The latest report, whose authors include members of the investigation team, says delays in telling public health officials may have contributed to the scale of the outbreak.
"The size and duration of this outbreak exceeded any other commercial restaurant-associated norovirus outbreaks in published literature. It is hoped that lessons learned from this outbreak will help to inform future action by restaurateurs especially in early notification to public health authorities once an outbreak is suspected. It is also notable that diners may often choose to inform restaurants directly rather than their doctors or public health authorities. It is important that both diners and restaurants are provided with better information about whom to inform and when to inform once an outbreak of illness is suspected," said the report.
The incident led to the rapid issue of updated guidance to the food industry by the Food Standards Agency in 2009, covering issues such as the management of staff illness. Last week, the agency reminded elderly and vulnerable people with health problems and pregnant women of the risks of eating oysters after a survey found more than three-quarters of British-grown oysters contained norovirus.
Blumenthal apologised to diners affected by the outbreak soon after the critical 2009 report. Demand for tables at the Fat Duck has not, however, diminished. Earlier this year the Michelin-starred restaurant was attracting tens of thousands of calls a day from diners, said Blumenthal, who recalled the poisoning incident as an "awful time".
A spokesman for the Fat Duck said: "The reported illness in February 2009 at the Fat Duck was confirmed as oysters contaminated at source by norovirus. At the time we voluntarily closed the restaurant and called in the authorities. We co-operated with all parties fully and transparently and received a clean bill of health to reopen after a 10-day investigation.
"We also received full support by our insurers who found no fault in our practices following a report from a leading UK independent specialist. There is still no guaranteed safety measure in place today to protect the general public with regards to shellfish and viral contamination. For this reason we still do not serve oysters or razor clams at the Fat Duck."

Listeria Cantaloupe Outbreak New Numbers Due This Week
Source : http://www.marlerblog.com/legal-cases/listeria-cantaloupe-outbreak-new-numbers-due-this-week/
By Bill Marler (Dec 05, 2011)
As of November 1, 2011, a total of 139 persons infected with any of the four outbreak-associated strains of Listeria monocytogenes have been reported to CDC from 28 states. The number of infected persons identified in each state is as follows: Alabama (1), Arkansas (1), California (2), Colorado (39), Idaho (2), Illinois (3), Indiana (3), Iowa (1), Kansas (10), Louisiana (2), Maryland (1), Missouri (6), Montana (1), Nebraska (6), Nevada (1), New Mexico (15), New York (2), North Dakota (2), Oklahoma (11), Oregon (1), Pennsylvania (1), South Dakota (1), Texas (18), Utah (1), Virginia (1), West Virginia (1), Wisconsin (2), and Wyoming (4). Nevada and Utah have reported their first case each since the last CDC update. Among persons for whom information is available, reported illness onset ranges from July 31, 2011 through October 21, 2011. Ages range from <1 to 96 years, with a median age of 77 years. Most ill persons are over 60 years old. Fifty-seven percent of ill persons are female. Among the 134 ill persons with available information on whether they were hospitalized, 132 (99%) were hospitalized. State and local health departments in these and other states are investigating other listeriosis illnesses to determine if they are part of this outbreak.
Twenty-nine deaths have been reported: Colorado (8), Indiana (1), Kansas (3), Louisiana (2), Maryland (1), Missouri (2), Nebraska (1), New Mexico (5), New York (2), Oklahoma (1), Texas (2), and Wyoming (1). Among persons who died, ages range from 48 to 96 years, with a median age of 81 years. In addition, one woman pregnant at the time of illness had a miscarriage.  Five of the illnesses were related to a pregnancy; two were diagnosed in newborns and three were diagnosed in pregnant women.
Ill will increase as will deaths as will miscarriages.

Disease linked to E. coli is serious
Source : http://www.courierpress.com/news/2011/dec/05/disease-linked-to-e-coli-is-serious/
By Betsy Neahring (Dec 05, 2011 )
I am one of those people who really doesn't enjoy cooking. While I appreciate the effort and artistry that goes into preparing a meal, I just don't enjoy knowing too much about my food before it hits the supper table.
Meat in particular changes a lot from pasture to plate, and I don't like to think about my delicious burger as someone's pet 4H project named Miss MooBelle.
Vegetables honestly aren't much better, as they often are covered in dirt for most of their lives. While I objectively realize that nutrient-rich soil is an important source of vitamins and minerals, part of me just doesn't relish the thought of eating mulch.
Fortunately, most of my concerns are unfounded, but each year a few contaminated food items lead to regional outbreaks of foodborne infections. One particularly nasty complication of these infections is a disorder known as hemolytic uremic syndrome.
Hemolytic uremic syndrome, or HUS, is a condition characterized by abnormal destruction of red blood cells, resulting in anemia. Platelets, which help the blood to clot, are destroyed as well, causing bleeding and bruising.
Damaged blood cells clog the filtering system, leading to kidney failure. HUS is the most common cause of acute renal failure in children.
HUS typically occurs following an infection in the digestive tract, often a strain of the E. coli bacteria. It is most commonly found in children younger than 5, and may be preceded by abdominal cramps, fever and several days of watery and/or bloody diarrhea.
As the disease progresses, symptoms can worsen and other signs of the disease, such as high blood pressure, decreased consciousness and low or no urine output become apparent.
If your doctor suspects your child has HUS, a variety of blood tests can be done to confirm the diagnosis. A stool sample often is collected to test for specific bacteria. Treatment is targeted toward easing your child's symptoms and preventing further problems, and may include IV fluids and blood transfusions.
If kidney damage is extensive, dialysis may be required.
HUS is a serious illness and can progress to seizures, coma and other forms of neurological involvement. Rarely, death can occur. Even in severe cases, however, the majority of children with HUS who receive prompt and appropriate treatment recover with no long-term damage.
While a number of infectious organisms have been implicated in the development of HUS, the disease is most closely linked to specific strains of the E. coli bacteria. Undercooked hamburger and unpasteurized milk are common sources of E. coli, but recent outbreaks have been associated with a variety of other foods as well. Lettuce, cheese, unpasteurized fruit juices/apple cider and prepackaged cookie dough all have been incriminated.
A large outbreak of HUS in Europe this summer was traced to a novel strain of E. coli from tainted sprouts. Interestingly, more adults than children were affected in this outbreak, leading some researchers to postulate that immune factors were involved.
But I think it may be related to the fact that children are too smart to eat a food that basically tastes like grass.
Although all the recent news reports about looming bacterial infections may make a trip to the salad bar sound like a dangerous adventure, a little common sense still goes a long way toward preventing problems.
You cannot control every step in the food supply chain, but you can reduce your risk by cooking ground beef thoroughly, avoiding unpasteurized milk and juices and washing fruits and veggies before eating. Food should be fun, not scary!
Dr. Betsy Neahring practiced pediatrics in Evansville for 10 years before (mostly) retiring to become "Daniel's Mom." Write to her at drbetsyneahring@aol.com.







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